Quote Of The Year

Timeless Quotes - Sadly The Late Paul Shetler - "Its not Your Health Record it's a Government Record Of Your Health Information"

or

H. L. Mencken - "For every complex problem there is an answer that is clear, simple, and wrong."

Wednesday, October 02, 2024

I Wonder How Long It Will Take Until We Establish A Proper Centre For Disease Control?

After the pandemic started to settle we were promised an OZ CDC

It there an sign as yet?

Christine Middap

Act now before ’pandemic amnesia’ sets in

27 Sept,2024

Melbourne was nearing the end of its first 100 days of strict lockdowns and premiers were cautiously planning to loosen border controls in October 2020 when federal opposition leader Anthony Albanese made a significant pledge to protect the country in future pandemics.

Australia couldn’t afford a repeat of the Ruby Princess debacle, where infected cruise passengers were allowed to disembark freely in NSW, or the unfolding disaster in aged care where 673 people had already died, he said.

“Our health, our lives and our economy all depend on us getting the response to future pandemics right,” Albanese said, vowing that a Labor government would establish a new body, the Australian Centre for Disease Control, to strengthen the country’s preparedness and lead the fight in future outbreaks.

It was an uncontroversial announcement – opposition health spokesman Chris Bowen correctly pointed out that peak health bodies had been calling for a central entity for more than 30 years; it was mooted by the Australasian Epidemiological Association at its inaugural conference back in 1987. “It’s time to get on with it,” Bowen said in 2020. “An Australian CDC would save lives and ease the pain of chronic illness.”

The same experts who looked to that promise and follow-up $90m post-election commitment with hope are now frustrated that this much-vaunted linchpin to Australia’s future pandemic response is inching along, losing momentum and serving as proof, they say, that lessons from the Covid era risk being lost.

Public consultation and expert roundtables were held in 2022, leading many to believe the government was pursuing its policy with zeal in the face of ongoing warnings that viral disease outbreaks were increasing in frequency and severity. The CSIRO says two novel viruses, on average, are appearing in humans every year and the proportion that gives rise to larger outbreaks is growing. In other words, this is no time for complacency.

“The pandemic demonstrated really clearly why a CDC body is important and we were delighted with the government’s announcement, but what’s happened since then has been puzzling,’’ Australian Medical Association president Steve Robson says. “Evidence that we’ve learned the lessons from the last pandemic would be a functional CDC, and we haven’t seen that yet. I would need to be convinced that we could cope with the next pandemic well at all.’’

Adjunct professor Terry Slevin, head of Australia’s peak body for public health, says the proposed centre should be far more advanced than it is and he doubts the necessary enabling legislation will be introduced in this government’s first term, as expected. He calls the lack of solid progress “pandemic amnesia”.

“There’s lack of certainty about the ACDC’s future and lack of clarity in relation to resources,” says Slevin, chief executive of the Public Health Association of Australia. “There’s still people wondering whether it will become a reality.”

Robson agrees. “It’s crunch time. I’m sceptical that this can be delivered by the government as promised, in the timeframe as promised,” he says.

In the wash-up from the Covid-19 pandemic many health and science groups – from the Australasian Epidemiological Association and the Doherty Institute to the Australian Nursing and Midwifery Federation and the Australian Academy of Science – recommended an ACDC to undertake real-time monitoring of infectious diseases, collect national data and provide expert and transparent advice to government. “It would provide for a co-ordinated national health response that gets away from individual state or territory political responses,” Robson says.

Here is the link:

https://www.theaustralian.com.au/inquirer/act-now-before-pandemic-amnesia-sets-in/news-story/bfa79852bf9cbe8eaa62e6a782f48bac

Typical Government – great announcements and bugger all action.!

Just pathetic – won’t happen in my lifetime I suspect!

David.

Tuesday, October 01, 2024

It Seems They Still Have Not Made The myHealthRecord Something Doctors Want To Use!

This appeared last week:

ANZ

Electronic Health Records (EHR, EMR)

GPs cry My Health Record 'overhaul' and more briefs

Also, Breast Cancer Foundation New Zealand is set to launch a national programme ensuring cancer therapy adherence.

By Adam Ang

September 27, 2024 07:17 AM

Australian gov't urged to raise My Health Record funding

An organisation of general practitioners in Australia has called on the federal government to upgrade the country's digital health record system.

"We’re calling for the federal government to overhaul My Health Record to improve its useability for Australians, GPs, and other health professionals," said RACGP President Dr Nicole Higgins in a statement.

This comes as RACGP found from the initial result of its annual survey that nearly a third of Australian GPs are rarely or not using My Health Record. More than 2,000 GPs are polled yearly in RACGP's Health of the Nation survey. 

"My Health Record can’t fulfil its potential to be the one-stop store for Australians’ health records without investment to improve its useability," Dr Higgins stressed. 

She insisted that My Health Record must capture more patient information and make it easier for GPs to search them, as well as ensure data interoperability and timely notification when patient records are updated. Dr Higgins also recommended implementing automation tools to make the system "more usable," particularly in capturing data from GP records.

Recently, the country's Productivity Commission found My Health Record "plagued by incomplete records and poor usability." Last year, the Strengthening Medicare Task Force also called for the modernisation of the "clunky" digital health records system. 

Here is the link:

https://www.healthcareitnews.com/news/anz/gps-cry-my-health-record-overhaul-and-more-briefs

Isn’t this just pathetic. If the Government has not worked out what the myHR needs to be after 12 years (it was initiated in 2012!) is there any chance insight and a purpose will suddenly drop from the sky?

And in the same week we have:

‘It’s a big job’: Doctors demand overhaul of $2b health data platform


Joseph Brookes
Senior Reporter

26 September 2024

Share

Almost one in three doctors aren’t using a national patient record database despite more than a decade and $2 billion of development, leading to fresh calls this week for an overhaul that can deliver productivity gains and prepare the platform for automation.

Health minister Mark Butler says ongoing upgrades funded by the government in 2023 and 2024 will deliver a better My Health Record (MHR) and “rich insights” from patient data.

But he is facing pressure for an accelerated usability overhaul from the Royal Australian College of GPs, which have linked the struggles to rising out of pocket costs for patients.

“It needs to capture more information for patients and be easier for GPs to search. It should share information with GP practice software and notify GPs when patients records are updated to support patient care and safety,” RACGP President Dr Nicole Higgins said.

“Automation will also make it more useable, such as automating data capture from GP records when patients consent.”

‘Clunky’: Health Minister Mark Butler says not enough data is flowing through My Health Record

Despite having existed in some form since 2012 and controversially switching to an opt out model in 2019, use of MHR is patchy, while the underlying platform is plagued by incomplete records and poor usability

A Productivity Commission report in May said only two per cent of documents uploaded to MHR are being looked at by other doctors, with some seeing the platform as a “shoebox of PDFs”.

According to RACGP survey results published this week, 31 per cent of doctors rarely or never use it.

The Productivity Commission’s report estimated a $5.4 billion windfall from better use of electronic medical records around the country because it would reduce patients’ time in hospital, while automation and artificial intelligence could deliver even more.

“The potential savings in general practice and other health settings would also be substantial,” Dr Higgins said.

“This money could then be re-invested back into reducing out-of-pocket costs for patients to help in the current high cost of living climate.

“We’re calling for the federal government to overhaul My Health Record to improve its useability for Australians, GPs and other health professionals.

In response to findings from a 2023 taskforce, which included the RACGP, Mr Butler accepted the platform needed an overhaul. He followed up with a $429 million funding commitment in the next federal Budget, which was topped up in the latest Budget in May.

“My Health Record is now old technology,” Mr Butler said in a statement to InnovationAus.com on Thursday.

“It still uses the old PDF format that Labor installed when we were last in government. It was cutting edge then, but it’s clunky now.

“That’s why the Albanese government is upgrading My Health Record to transform it from a ‘PDF document system’ to a data rich platform to provide rich insights to consumers and health professionals.”

Behind the scenes, the Australian Digital Health Agency responsible for MHR has been transitioning away from a single vendor for the platform, Accenture.

The tech services giant has clashed with the agency while being paid $750 million to operate MHR after securing contracts that broke procurement rules.

The issues led to a move away from Accenture — which now represents one third of vendor costs for MHR, down from 100 per cent prior to 2021 —  and prompted a wider consideration of insourcing national health platforms.

In the meantime, users of the platform are frustrated.

“It’s a big job to improve our flagship national health data system, and we recognise that the Australian Government and the Australian Digital Health Agency are taking steps to this end,” Dr Higgins said. “However, this work must continue to be prioritised because it will have significant benefits for Australians, and our health system.”

Here is the link:

https://www.innovationaus.com/its-a-big-job-doctors-demand-overhaul-of-2b-health-data-platform/

Isn’t this just pathetic. If the Government has not worked out what the myHR needs to be after 12 years (it was initiated in 2012!) is there any chance insight and a purpose will suddenly drop from the sky? Also there is no evidence I can see the RACGP (or anyone else) has a clue what to do with it as well! Let us remember it costs millions of dollars per month and has never been proven to offer any real benefit!

I said it was a lemon in 2012 and it still is. Way past time to kill it off and spend the money on something useful!!!

David.

Sunday, September 29, 2024

Some Health Apps Seem To Be Getting Very, Very Expensive!

They would sure want to make a real positive difference – and fast!

Here is an article discussing some of the newer ones!

Would you pay $1500 a month for a health app?

By David Swan

September 29, 2024 — 5.00am

A cohort of buzzy digital health start-ups is jostling for a piece of the nation’s lucrative healthcare market but are facing questions over their strategies, pricing and efficacy, with some charging nearly $1500 a month before they’ve publicly launched.

The preventative health sector has taken flight over the past 12 months, spurred by high-profile American figures like Andrew Huberman, Joe Rogan and Dr Peter Attia, who espouse the benefits of “biohacking” and the use of technology to help become “superhuman”.

The excitement surrounding so-called health super apps has now spread to Australia. A crop of start-ups is winning millions of dollars in venture capital funding as they race to onboard local users, promising comprehensive diagnostic testing, coaching, and performance optimisation.

Some consumers have reported early positive results from the highly personalised, data-focused apps. But medical groups, including the Royal Australian College of General Practitioners, are concerned that several of the platforms offer few health benefits and may, in fact, be causing harm.

In some cases, customers are paying a hefty premium for a product not yet ready for public launch. One health app, Compound, was charging users $995 a month (or $1495 with medication) – more than 10 times the cost of a typical gym membership – before it hit pause on its operations last week.

Related Article

Compound is the men’s longevity arm of telehealth provider Eucalyptus. Last year, it was valued at $520 million and has received financial backing from venture capital firms Blackbird and AirTree, which declined to comment for this piece. More than 4000 Australian men had registered their expression of interest in its all-in-one men’s health app, which encompasses diagnostics, nutrition, and training.

This month, Compound suspended operations, however, informing its customers via email that the platform required an overhaul. Its executives and engineers are now rebuilding it from scratch.

Eucalyptus chief Tim Doyle said that the issues stemmed from scaling up what was a very labour-intensive, manual offering.

“Scaling this has been really hard. It’s a concierge service. Really fundamentally, our members get feedback on how they’re doing their gym routines and workouts at a granular level,” Doyle said.

“They might say ‘hey I’m struggling with a sore shoulder, and I’m travelling for a week, how should I modify my gym routine?’ – and that is not an easy thing to scale.

“The best care is very human and manual, and that is hard to scale and expensive to scale, so we need to find a way to do that.”

Compound’s program architect, Dan Cable, wrote in an email to customers that it had been a “challenging launch period” for the start-up.

“We are extremely grateful that you joined Compound so early while much of our offering was still a prototype,” the email said.

“There’s a tension between launching early and delivering a high bar with a very manual experience while also rebuilding the underlying op-model, so we’ve decided to pause operations by the end of the year so that we can set up for relaunch in H2 2025.”

That tension between taking the time to deliver a reliable product and not missing the boat is not unique to Compound and is persistent throughout the health app sector.

Another Australian app, Bright, said it had sold more than 2500 “early access” passes to users globally, half of whom are based in the US. Described as the “last health app you need”, it connects meal logging, sleep tracking, heart monitoring and more into one subscription. Bright is charging $99.99 for its early access pass, which gives users lifetime access, and it will cost $299.99 a year at public launch.

Described as the “last health app you need”, the Bright app connects meal logging, sleep tracking, heart monitoring and more into one subscription.

Bright was slated to debut in the App Store this month, but founder and chief Bryan Jordan said it would now come in October after a few more weeks of “adding some final polish.”

“Bright is a super app for health for everybody that’s affordably priced,” Jordan said. “First impressions count on the App Store, and if we want to be the ‘last health app’ then we have a high bar to cross at the start.

“We’ve mostly self-financed the $3.5 million we’ve brought in because we haven’t been satisfied with terms made by venture capitalist investors ... Self-financing means our development has been slower than we’d like as we ran a software agency in parallel and reinvested the $1 million in profit to develop Bright.

“‘Moving fast and breaking things’ is appropriate if you’re first to market, but if you’re last to the party, then we need to make sure the party only starts when we arrive.”

In what is already shaping up as a highly competitive space, Jordan said he remained sceptical of the business model of the likes of Compound, given how expensive its subscription is.

“I’ve yet to hear from independent doctors, surgeons or specialists advocating for consumers to spend $1000 per month to monitor their health, and I’ve yet to read any supporting literature from reputable medical journals,” he said.

“I find it surprising that with these programs, there isn’t a discussion on the consequences of ‘too much medicine’... Following the science and not the trend has always brought better patient outcomes.”

Doyle responded that Compound’s $1000 monthly price tag could be attributed to its extensive diet planning and exercise regimes.

“People do spend $1000 per month on those things,” he said, adding that once Compound scales up, it would more likely cost about $200 a month without medication.

“If we can build it for the first 10,000 people over the next year, then for a million people after that, I think the cost of delivering the service is going to come down as AI agents and [large language models] play a greater role. I see this as something we can scale to millions of patients over the next five years.”

Another high-profile player is Everlab, which has received $3 million in venture capital funding from European fund b2 Ventures, as well as local funds Ten13, Flying Fox, and AfterWork Ventures.

Everlab’s business model is an annual subscription of $250 a month, or $3000 a year, for its “preventative health membership”, billed upfront. The company also takes a deposit of $299 to experience the program before committing.

The start-up said it had worked with 300 customers to date. It pairs customers with doctors, consolidates the customer’s historical health data, and then uses AI models to assist clinicians with a diagnosis.

Everlab chief Marc Hermann said the combination of rising chronic disease rates alongside an ageing population was placing immense pressure on the healthcare system.

Hermann said where Compound had largely marketed to young men who could be described as “tech bros” interested in optimising their performance, Everlab’s focus had been on targeting ordinary middle-aged individuals.

”Most of our customers are middle-aged working professionals,” Hermann said. “This is a demographic that has seen friends and family struggle with their health. They’ve heard about friends having sudden heart attacks or receiving an unexpected cancer diagnosis. Or they’ve simply seen their parents grow old and their quality of life diminish.

“For this customer, there are many things we can do to intervene and course correct.”

One Everlab customer, Andrew, is 61 and a former managing partner of a consulting firm. He says he started the Everlab program six months ago, and it found disproportionately high levels of visceral fat. This led to recommendations including a personalised diet plan with calculated protein intake for body size and a sleep assessment.

“I now have someone who collects and analyses all my existing and future health data. From the analysis has flowed a set of additional tests that have led to a range of positive outcomes.” Andrew said.

While the race to build Australia’s “health app of the future” continues apace, Michael Clements, vice president of the Royal Australian College of General Practitioners, warns of several concerns.

The apps could provide false reassurance. If patients have made bad health choices and an app tells them they’re OK, it could lead to a false sense of security. He also warned of “incidentaloma,” a medical term in which patients find something they weren’t looking for in the first place, often leading to unnecessary testing and treatment.

“There certainly has been harm where people have had complications from surgeries or complications from biopsies and procedures looking at things that were never even being looked for in the first place,” Clements said.

“We actually already know what makes healthy people. We know that keeping physically active, keeping outdoors, keeping engaged with people and humans and social interaction, having a balanced diet heavy in vegetables, fibre and nutrients, these are what work.

“The evidence is clear that people get their best health care from a GP that knows them and that the longer you have a relationship with a GP, the longer you do live. And these businesses really do need to be accountable for the risk of harm that they’re giving to their patients.”

Here is the link:

https://www.smh.com.au/technology/would-you-pay-1500-a-month-for-a-health-app-20240926-p5kdr7.html

I wonder if the price here is being set at such a level that you would not follow all the advice for fear of financial loss?

I am sure many would find the cost a motivating factor for use once they had paid!

What do you think would be a fair maximum for an app subscription?

David.

 

AusHealthIT Poll Number 766 – Results – 29 September 2024.

Here are the results of the poll.

Are We Devoting Enough Resources Into Addressing Female Health Problems?

Yes                                                                                  10 (37%)

No                                                                                   15 (56%)

I Have No Idea                                                                 2 (7%)

Total No. Of Votes: 27

A fairly clear vote,  with the feeling more could be done in women’s health.

Any insights on the poll are welcome, as a comment, as usual!

Not a bad voting turnout. 

2 of 27 who answered the poll admitted to not being sure about the answer to the question!

Again, many, many special thanks to all those who voted! 

David.

Friday, September 27, 2024

This Is A Great Tale About A Man Who Gave Us A Great Deal That I Had Never Heard Of!

 

This appeared last week:

George Berci: The forgotten, humble doctor who changed surgery for all mankind

Alan Howe

20 September, 2024

The cursory shortlist of Melbourne University alumni on its website is a curious document. It lists a comedian of whom I’d never heard, Gillian Triggs, whose calamitous years as president of the Australian Human Rights Commission resonate still, and Germaine Greer, whose dreary prose once littered bookshops.

I called the university to ask about the death of George Berci. They had never heard of him.

But there he is, in capital letters in the Faculty of Melbourne Handbook 1969 as: Reader in Experimental Surgery, GEORGE BERCI, M.D. (Szeged).

Others named that year include Frank Macfarlane Burnet, the virologist who won a Nobel prize for medicine in 1960, Gustav Nossal, who led the world in the study of the formation of antibodies and immunological tolerance, and David Penington, who helped make Australia the leader in responding to the threat of HIV and promoted the idea of needle exchanges – a world first.

Berci changed more lives than all of them. He quietly pioneered the art of non-intrusive surgery, inventing laparoscopy so that our organs could be comprehensively examined, treated and repaired via a keyhole insertion through the skin.

The instruments and techniques he developed – and the decades he spent teaching their use – changed modern medicine the world over, saved lives, extended them, and made medical intervention less painful and perilous. He was an inventor, understood how surgical instruments might be improved, and a esteemed conductor of medical “orchestras” thankful that fate had cast them into his orbit.

None of which was a surprise. For generations, the Berci family business was making music.

He began to revolutionise surgery in Melbourne where he arrived in 1956 from Hungary after that country’s attempted revolution was murderously suppressed by the Soviet Union’s Nikita Khrushchev.

Stepping from a ship at Melbourne’s Station Pier, he spoke not a word of English. (Another young Hungarian arrived there that same year and neither could he speak English, but Gab Kovacs would go on to pioneer IVF.)

Berci set out to learn 100 English words a day every day. Within a year he knew more than most native speakers and certainly enough to interest Melbourne University and the Royal Melbourne Hospital. He was soon suggesting new technology to make crudely invasive surgical procedures easier and more comfortable for all concerned. No longer would doctors slice a large access point to examine your colon, prostate, oesophagus, bladder or kidneys.

Through laparoscopic techniques the gallbladder, spleen and appendix could be removed. Urological and thoracic surgery was greatly simplified, the hernia and colon could be repaired and gynaecological disorders rectified with remarkably fast recovery times. Modern car mechanics use similar techniques. A “waterproof HD Endoscope USB type-C borescope inspection snake camera” was on eBay yesterday for $13.22.

The large fixed-imaging equipment bearing a television camera would in time give way to small, flexible tubing with a minute camera at its tip relaying images to a screen in the surgery that many doctors at once could examine. The modern endoscope was born. At this stage not all Australians had a television.

Later, Berci would develop a low-radiation fluoroscope for live X-ray imaging.

In 1967, he was lured to Cedars-Sinai Medical Centre in Los Angeles where he worked the rest of his life, turning up to his office this year at the age of 103.

He was a humble man whose background rumbled deeply from the tectonic clashes instigated by Germany from the 1930s and could so easily have become an almost anonymous statistic of hate.

But he survived, sought an education his family could afford, and not the indulgence of music – his father and grandfather had both been recruited from Hungary to the Vienna Philharmonic Orchestra when he was a child and he had taken violin lessons from the age of three (“I missed a lot of soccer games,” he would recall).

The family fled Austria, returning to Hungary where he was arrested and recruited to a labour camp of 5000 young men for two years (wearing a yellow star to denote his religion) and forced into building defensive lines across the mountains. It was cold and they were barely fed. Many died. Being transferred to Auschwitz they changed trains in Budapest. “It had been bombed and everyone had disappeared. We escaped … an interesting moment.”

His father and grandfather had been consumed by the Holocaust, but his mother survived. Australia was still a decade away. Berci contracted Covid last month.

His family recall him inserting scopes into violins and cellos marvelling at what happened there: “It was amazing,” he said.

George Berci, surgeon and inventor. Born, Szeged, Hungary, March 14, 1921; died, aged 103, in Los Angeles, August 30.

Here is the link:

https://www.theaustralian.com.au/science/george-berci-the-forgotten-humble-doctor-who-changed-surgery-for-all-mankind/news-story/61d32b79f0ce8c5fe138e88cf9b3325f

What a fantastic story about someone about whom I know absolutely nothing – to my shame!

What a fabulous and inventive contribution!

David.

Thursday, September 26, 2024

My Alma Mater Seems To Have Got Itself Into A Right Pickle – As They Say!

This appeared last week!

Sydney Uni to review complaints system as Jewish students call on Scott to resign

By Christopher Harris

September 21, 2024 — 6.26pm

The University of Sydney’s complaints system will be the focus of an external review after a senate inquiry looking at the treatment of Jewish students unearthed a trove of complaints and vice chancellor Mark Scott was forced to admit he “failed”.

This year, the university has been home to a pro-Palestinian encampment which was infiltrated by radical Islamist group Hizb ut-Tahrir and it was singled out as among the worst places to be a Jewish student at a senate inquiry into antisemitism at Australian universities on Friday.

Speaking at the inquiry, Scott conceded he had “failed them and the university has failed them”.

A university spokeswoman on Saturday said an external review would look at the institution’s complaints handling system.

“Many of the testimonials in the submissions shared to the inquiry were deeply moving and were not issues that had come through our system, highlighting the need to make sure our students and staff feel secure when seeking support and lodging a complaint,” she said.

“When the encampment ended, we recognised there was more to do, and this is why we have commissioned an independent external review of our relevant policies and processes.

“This process will include an assessment of our complaints handling procedures to ensure our community feels safe and comfortable to make a complaint.”

Australasian Union of Jewish Students vice-president Zachary Morris said on Saturday that despite students raising complaints of antisemitism with Scott and the university, little had been done so far and he called for Scott to resign.

“When we would lodge a complaint, they said there wasn’t enough information or would only act if there was footage. It has been like pulling teeth,” Morris said.

“If you say you’re going to remove the swastikas, can you actually go do that? Not just say you’re going to do that. His position is no longer tenable,” he said.

One submission from second-year veterinary student Dror Liraz said: “I have suffered the encampment, calls for intifada (by students, professors, and politicians on campus), harrowing graffiti and daily harassment from those trying to spread anti-Jewish sentiment.

“But my experience is comparatively an untroubled one. I have heard stories of students stalked to class, doxed, threatened in exams and yelled at by an auditorium full of antisemites.”

Scott’s admission of failure on Friday was met with scepticism from Jewish groups who say words and platitudes about antisemitism are not matched with concrete action to address it on campus.

The Tertiary Education Quality and Standards Agency said universities across Australia had received 598 complaints related to encampments and protests since Hamas’ October 7 attack killed some 1200 people. Israel’s subsequent attacks in Gaza to eliminate Hamas have killed more than 40,000 Palestinians.

Executive Council of Australian Jewry co-chief executive Peter Wertheim said the admission of failure was an essential first step towards righting any wrong.

“But there needs to be evidence that the nature and the extent of the failure are fully understood and that the appropriate conclusions have been drawn.

“If that were the case, we would have also had a proper public apology and a detailed commitment to take corrective action. University leaders have to date been a rich source of bland platitudes, but have fallen woefully short when it comes to practising what they preach.”

Here is the link:

https://www.smh.com.au/national/sydney-uni-to-review-complaints-system-as-jewish-students-call-on-scott-to-resign-20240921-p5kcdq.html

This looks to me like things are pretty much out of control and that we are going to see some heads roll pretty soon as a clean up is attempted.

Might be a few fun-filled weeks as this spirals out of control!

Watch this space.

David.

Wednesday, September 25, 2024

You Were Never Going To Stamp Out A Highly Profitable Enterprise By Banning It!

This appeared last week:

Vape-flation: prices have surged, but retailers are still flouting the ban

By Millie Muroi

September 21, 2024 — 4.50pm

Illicit vape prices have surged in the two months since a nationwide ban on their sale outside pharmacies began, fuelling concerns about a lucrative black market as shops across the country continue to stock the devices.

This masthead visited a dozen tobacco and convenience stores across Sydney and found all had vapes available: some on display in glass cases, most pulled out from beneath the counter.

Some were brazenly advertising vapes. Others had scratched out the word on their signs but had vast selections for sale when queried.

Pulling out a box with 5000 puffs, one seller said: “This one is $60. Last year, I used to sell three for $60.”

Asked why vapes had become so expensive, they said, chuckling, “because they’re illegal”. None of the sellers approached by this masthead asked for proof of age to purchase.

Vapes, which may have cost as little as $3 each from factories in China, were offered to this masthead in Sydney this month for between $40 and $60.

It illustrates the challenge ahead for Health Minister Mark Butler as he implements his world-leading vape ban.

Under the new laws, the only legal vapes are pharmacy products that have limited nicotine and come in menthol, mint or tobacco flavours, designed for people who want help to quit smoking.

All retail, such as convenience stores or petrol stations, were banned from selling vapes from July 1. Butler introduced penalties of up to $2.2 million and seven years’ jail for retailers who flout the rules by selling single-use vapes in a range of fruity or sweet flavours, which are popular among young people.

The final phase of the laws will come into effect in October, when over-18s will be able to buy vapes from a chemist without a prescription after consulting with a pharmacist. The Pharmacy Guild of Australia declined to comment on the price of prescription vapes that will be available in pharmacies.

Butler said state authorities had been ramping up their enforcement activity, conducting raids across the country, and high schoolers were reporting vapes were harder to find.

The Therapeutic Goods Administration and Australian Border Force (ABF) have seized 5.2 million devices so far this year, with an average street value of about $30 each, after Butler introduced tougher laws at the border in January.

“My message to those continuing to sell vapes is we are deadly serious about enforcing this ban,” Butler said. “Vape stores across the country are winding up their leases and closing their doors.”

An ABF spokesperson said those raking in profits from illegal vapes included organised crime groups involved in the illicit tobacco trade .

Experts are calling for more restrictions on access to vapes after health data revealed several primary school children were suspended over e-cigarette use.

International suppliers were actively seeking ways to sidestep border controls, they said, with high levels of misdeclaring and misdescribing vapes as household goods or gym equipment.

Between October 2022 and April 2023, the ABF seized just 3 per cent of the up to 28 million illicit vapes that came into the country. The increase in seizures in recent months probably indicated that stockpiles were running low and importers were trying to bring more vapes into the country, the spokesperson said.

Butler has invested significant political capital in making sure the ban works, warning that vapes are a cynical ploy from Big Tobacco to hook a new generation on nicotine.

The ban is opposed by the Coalition, which instead backs a strictly regulated consumer model that would sell vapes like cigarettes.

Shadow health minister Anne Ruston said Labor’s prohibition approach was not working. “Kids are still being targeted by a thriving and dangerous black market,” she said.

“That is why we have committed to moving to a regulated approach if elected.”

Australian Medical Association president Professor Steve Robson said that while “isolated retailers” were flouting laws, the effects of the ban were heading in the right direction.

“Illegal vapes will be stamped out by the end of the year with any luck,” he said.

Roy Morgan data shows 7.1 per cent of Australian adults, or 1.5 million people, vaped in July – about 300,000 fewer than the same time last year, and down from a peak of 9.2 per cent in December.

However, Deakin University criminologist and forensic psychologist David Bright said restrictions on vapes could push consumers towards cigarettes and tobacco.

Butler also said there had been a crackdown on vaping advertising. Since July 1, 118 warnings have been issued to advertisers promoting vaping goods, and since the start of the year, more than 8000 requests have been made to digital platforms to remove advertisements. About 58 websites have been, or will be, blocked from public view.

Here is the link:

https://www.smh.com.au/politics/federal/vape-flation-prices-have-surged-but-retailers-are-still-flouting-the-ban-20240913-p5kad1.html

Talk about pushing it up hill with a pointed stick! A ban , with essentially no enforcement, was never going to work and now we have the worst of both worlds, with vapes being sold at fantastic mark ups behind the counter!

A real policy win!

Surely the next step is just to legalise vapes – like cigarettes etc. -  and use price – via an excise – to regulate the volume.

I reckon the Government is ‘snookered’ – what do you think?

David.

Tuesday, September 24, 2024

This Is A Really Very Sad and Disturbing Report. Surely We Can Do Better! I Also Wonder Why My Experience Of Things Is So Different To This?

It appeared last week:

Health

One in 20 Australian adults found to have suffered reproductive coercion and abuse

Australian Study of Health and Relationships finds 3.9% of women aged 16-69 had experienced contraceptive interference and 4.9% forced abortion

Natasha May

Sun 22 Sep 2024 06.00 AEST

One in 20 Australian adults have experienced reproductive coercion and abuse.

That is among the findings of the Australian Study of Health and Relationships, released this week, the first time researchers in Australia have estimated the national prevalence of behaviour used to control a person’s reproductive autonomy.

Reproductive coercion and abuse (RCA) can include interference with contraception by a partner, forced contraception or sterilisation, and control of pregnancy outcomes by forced abortion or forced pregnancy.

Questions about these experiences were added to the country’s largest and most comprehensive study of sexual and reproductive health, conducted once a decade.

Dr Allison Carter, the group leader of the Sexual Health and Reproductive Equity (SHARE) Research Group at the Kirby Institute, presented preliminary findings around RCA prevalence from the third ASHR this week at the International Union Against Sexually Transmitted Infections (IUSTI) world congress in Sydney.

From analysing the survey data collected between 2022-2023 from a nationally representative sample of 14,540 people aged 16-69 years, the researchers found that, among women, 3.9% had experienced contraceptive interference, 2.7% had experienced forced sterilisation or contraception, 4.9% had experienced forced abortion and 1.9% forced pregnancy.

“In all likelihood, it’s probably an underestimation because we know people tend to under report experiences of violence, and also people might not recognise what’s occurring to them,” Carter told Guardian Australia.

“It might come in the form of emotional manipulation or more subtle insidious pressure to get pregnant and to keep a child when you may not want to.

“It might involve more overt threats to keep this child, otherwise ‘I’m going to leave the relationship’ – and if it’s a situation where a female partner has less social and economic power and are dependent on that relationship, they might feel intense pressure.”

It can also be overt or actual physical violence – for example, in the case of forcing a woman to choose a particular pregnancy outcome such as abortion, she said.

While RCA was primarily committed by partners, women did also commonly experience perpetration from their parents, with nearly one in five (19%) women who reported forced abortion saying it was perpetrated by their parents.

The prevalence of RCA rose drastically among socioeconomically marginalised men and women including people in contact with the justice system, people with a history of substance use, individuals with disability, those who experience violence, and gay and bisexual people.

For example, one in four women who had been in prison had experienced contraceptive interference (25.3%) and forced abortion (24.9%), while 15.2% of men living with a disability had experienced contraceptive interference.

The rate of men who reported partner interference with contraception was 8.4% – more than double the proportion of women – while 2.2% had experienced forced vasectomy.

However, Carter cautioned that to understand the data’s significance, researchers are still carrying out further qualitative research interviewing study participants to better understand people’s lived experience.

She also highlighted that when men experience partner interference with contraception, it is occurring through deception, for example a woman lying to a partner about using the pill. While that was not a healthy relationship dynamic, it could be different from the fear and control which characterises RCA among women, she said.

“A lot of the reasons behind women’s deception are rooted in women’s lesser social and economic status, and so if we want to talk about prevention, we really need to be talking about addressing disadvantage,” Carter said.

RCA has strong associations with intimate partner and sexual violence, although it can occur in isolation, making it trickier for healthcare professionals to pick up on “because there’s no other red flags”.

The findings also showed RCA was associated with a range of physical, mental and sexual reproductive health outcomes. “So it’s not just limited to reproductive health, but in effect it can affect all aspects of your life,” Carter said.

“Disagreements about whether or not to have a child are very common, and one person they want it and another may not – that’s normal. What’s important though is that people are able to navigate those disagreements in healthy way.”

Dr Kari Vallury, a research fellow at Griffith University with a focus on reproductive coercion and abuse, said having national prevalence data on the topic for the first time was “incredible”.

Vallury said it was also the first time ever in a national study anywhere in the world that “all four directions of RCA” have been measured – coerced or forced pregnancy or contraception, as well as pressure to end or continue pregnancy. “Historically forced abortion has been left out and it’s only measured contraceptive interference.”

Vallury said previously data has shown a 15% prevalence of RCA among pregnancy options counselling clients, “which you would expect to be high given the cohort but now we can really compare that and have a look at what’s happening in the whole community”.

Here is the link:

https://www.theguardian.com/australia-news/2024/sep/22/one-in-20-australian-adults-found-to-have-suffered-reproductive-coercion-and-abuse

I really do wonder about the sources of such statistics as what they report really does not accord with my life experience. Either I am very sheltered or very lucky!

I would be curious to hear from people who have life experience that confirms what is written above!

David.